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心脏瓣膜脱垂导致恶性室性心律失常的手术中对乳头肌进行冷冻消融。

Cryoablation of Papillary Muscles at Surgery for Malignant Ventricular Arrhythmias Due to Mitral Valve Prolapse.

机构信息

Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Vic, Australia; The Royal Melbourne Hospital, University of Melbourne, Melbourne, Vic, Australia.

Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Vic, Australia.

出版信息

Heart Lung Circ. 2022 Sep;31(9):1285-1290. doi: 10.1016/j.hlc.2022.04.058. Epub 2022 Jun 10.

Abstract

BACKGROUND

Mitral valve prolapse (MVP) is relatively common condition and while generally benign a small subset of patient suffers from malignant ventricular arrhythmias (MVA) and sudden cardiac death (SCD).

METHOD AND MATERIAL

We report three cases of mitral valve prolapse, mitral regurgitation and malignant ventricular arrhythmias refractory to medical therapy, who had surgical cryoablation at the time of surgery on the mitral valve.

RESULTS

During a follow-up period ranging from 3 to 11 years all three patients have remained free of ventricular arrhythmias and cryoablation lesions targeting the base of the papillary muscles have not caused any detrimental effect on the valve function.

CONCLUSION

Surgical cryoablation of papillary muscles as described in this article should be considered in MVP who suffer from MVA, aborted SCD or frequent ventricular ectopics likely to cause LV dysfunction.

摘要

背景

二尖瓣脱垂(MVP)是一种相对常见的病症,虽然通常是良性的,但一小部分患者会出现恶性室性心律失常(MVA)和心脏性猝死(SCD)。

方法和材料

我们报告了三例二尖瓣脱垂、二尖瓣反流和对药物治疗难治的恶性室性心律失常的病例,这些患者在二尖瓣手术时同时进行了二尖瓣的冷冻消融术。

结果

在 3 至 11 年的随访期间,所有三名患者均未出现室性心律失常,针对乳头肌基部的冷冻消融病灶并未对瓣膜功能造成任何不良影响。

结论

对于患有 MVA、心脏性猝死发作或频发可能导致左心室功能障碍的室性早搏的 MVP 患者,应考虑采用本文所述的乳头肌冷冻消融术。

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